Individual
KIMBERLE ANNE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
401 PROMISE WAY LN, MEDINA, TN 38355-6967
(731) 462-0020
Mailing address
6 WYNDELAKE CV # 6, JACKSON, TN 38305-7889
(731) 234-5461
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2216
TN
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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